Surgical approaches to the pituitary adenoma have undergone numerous refinements. Surgery on the pituitary adenoma is increasingly being performed through an endoscopic approach. The aim of this study is to report the results of a consecutive series of patients undergoing pituitary surgery using a pure endoscopic endonasal approach(EEA) and to evaluate the efficacy and safety of this procedure.

We reviewed 24 consecutive patients with pituitary adenoma who underwent purely endoscopic transsphenoidal resection of their lesions. The patients' clinical outcomes, including remission rates, degrees of tumor removal, and complications were evaluated.

Between September 2000 and August 2009, 76 patients with pituitary adenoma were operated on at Ewha University Mokdong Hospital. Of these, 24 patients were operated on using EEA. There were 18 nonfunctioning, 4 growth hormone-secreting, and 2 prolactin-secreting adenomas. Gross total removal was achieved in 62.5% of the cases after surgery. Visual disturbance was seen in 18 patients, which was improved in all patients. The main cause of failure of total removal was invasion to cavernous sinus. The remission results for patients with nonfunctioning adenomas was 83.3% and for functioning adenomas were 83.3%(75% for GH hormone-secreting, 100% for prolactin hormone-secreting), with no recurrence at the time of the last follow-up. Post-operative complications were present in 4(16.7%) cases. Three cases showed immediate postoperative CSF leakage, one case showed transient diabetes insipidus. There was no death related to the procedure in this series.

The endoscopic endonasal approach for resection of pituitary adenomas, provides acceptable results representing a safe alternative procedure to the microscopic approach. This less invasive method, associated with a small number of complications, provides acceptable tumor removal rates and represents an important tool for the achievement of good results in the pituitary surgery.

Vaginal pH change is known as one of the risk factors for recurrent lower urinary tract infection in female. The objective of this study was to analyze the correlation between lower urinary tract infection & overactive bladder revelation and vaginal pH by age group.

Subjects were schizophrenic out-patients, who fufilled DSM-IV diagnostic criteria, and their families.

This study found a positive correlation between age and vaginal pH(p=0.000). It also found that the contraction of cystitis patients was high in older age group(p=0.035). However, vaginal pH was not a significant factor to the contraction of cystitis(p=0.258). In older age group, the number of overactive bladder patients was higher than that of younger age group(p=0.05), while vaginal pH was not a significant factor to the contraction of overactive bladder(p=0.376).

Diseases that cause lower urinary tract symptom such as overactive bladder and recurrent cystitis increase in proportion to age. Vaginal pH also increases in proportion to age. However, vaginal pH is not a significant factor to the contraction of lower urinary tract symptom when the age is revised.

This case highlights the necessity of the functional and structural evaluation of kidney to prevent the serious complication such as acute renal failure before the administration of ACEi and/or ARB.

Leiomyoma is a benign tumor arise from smooth muscle and distributed wherever smooth muscle is present. Its common elective location is in uterus muscle and limb localization is rare. When it occurs in the extremity, it is more common in the legs, ankle, and foot than it is in the upper extremities. Especially on leiomyoma on the finger tip is extremely rare. This 36-year-old woman presented with a painful mass of the distal phalanx of her left thumb. It was about rice sized movable mass with firm consistency.

The round shaped mass in the left thumb was approximately 0.5×0.4cm in size. It was slowly growing mass without skin color change, bleeding nor ulceration. Under the local anesthesia, The patient underwent surgical excision .The masses were in deep subcutaneous and no connection with right maxillary sinus.

Macrosopic description of the mass is round and encapsuled, grayish nodule with size of 0.5×0.4cm. Microscopic study demonstrated a capsulease lesion of elongated cells white monomorphic cigar-shaped nuclei without atypia. The immunohistological phenotype was positive for Actin, which is marker for smooth muscle, but negative for S-100.

It is extremely rare to find leiomyoma origin from finger tip. Therefore the tumor is difficult to diagnosed before surgery. Only histological study can confirm the diagnosis. Complete surgical excision provides the most effective means of treatment.